eadaches are probably the most frequently reported medical condition today. Although not life-threatening, these painful episodes can interfere with normal work and leisure activities and greatly diminish the joys of daily life. This is especially true in those who experience frequent headaches - a large segment of the population. Over 45 million Americans, in fact, report chronic headaches. Astonishingly, about 12 million get a headache every day. Not only are headaches painful, they are also frustrating, because they are so difficult to treat. Many people, in fact, don't even bother to report headaches to their physicians anymore, because they assume that nothing can be done for them.

But of course there are remedies. For many headaches, mild analgesics are the preferred treatment, and they are often effective. Wouldn't it be nice, however, if there were some preventive measure that could be taken to ward off headaches before they even started? A recent report in Headache, a medical journal whose name whines for itself, suggests that supplementation with 5-hydroxytryptophan(5-HTP)may be an effective means for reducing the frequency of tension-type headaches.1

SEROTONIN IS A KEY NEUROTRANSMITTERGiven that headaches are so common, you might think that their causes were well understood. Sadly, however, this is not the case. Although there is a general understanding of the biological mechanisms that underlie the progression of headaches, the molecular details of these processes have yet to be unraveled. What is known, however, is that neurotransmitters are involved in the process (see sidebar). Consequently, neurotransmitters and their receptors have long been the specific targets of compounds designed to ease the pain of headache.

With 5-HTP, the number of days with headache was reduced by 55.1%, versus only 27.2% in the control group.

An especially important neurotransmitter is serotonin - also called 5-hydroxytryptamine, or 5-HT - which is produced in brain cells on an as-needed basis from its chemical precursor, 5-hydroxytryptophan, or 5-HTP. Serotonin plays a vital role in brain chemistry and helps to regulate the activity of other neurotransmitters. It is involved in a number of processes, including mood regulation, pain transmission, sexual behavior, eating habits, and sleep patterns.

LOW SEROTONIN IS IMPLICATED IN HEADACHESNot surprisingly, many things can go awry when serotonin levels are low. Reduced levels of this important molecule can lead to depressed, anxious, irritable, impulsive, or abusive behavior; they can cause insomnia; or they can lead to headache pain. A number of studies have demonstrated that taking a serotonin precursor such as 5-HTP is an effective way to treat - or, better yet, prevent - such problems.2

One of the two main causes of low serotonin levels is aging. The other is stress, that inescapable factor of modern daily life. And stress-related problems are so pervasive that, in his book 5-HTP, The Natural Way to Overcome Depression, Obesity, and Insomnia, Dr. Michael T. Murray writes that he considers "serotonin-deficiency syndrome to be one of the most widespread and debilitating medical problems of our time."3

5-HTP BOOSTS SEROTONIN LEVELSIt has been suggested that chronically low serotonin levels may lead to chronic headaches. This is because serotonin deficiency is thought to lower the brain's threshold for the perception of pain signals from elsewhere in the body (the brain itself is insensate - it cannot feel pain). Thus, lower levels of head pain will register as various kinds of headaches, including tension headaches and migraines.

But supplementation with 5-HTP can boost serotonin levels, and several studies have shown that 5-HTP effectively reduces headache pain. In one such study, 48 children of elementary and junior high school age were treated daily with 4.5 mg of 5-HTP per kilogram of body weight. Thus, a 50-kg child (110 lb) would receive 225 mg of 5-HTP. This treatment reduced headache frequency by 70% in the treated children, compared to only 11% in the control group, which received a placebo.4

5-HTP TESTED ON CHRONIC HEADACHEIt pains us to think that children get headaches at all, and who among us would not gladly take their pain on ourselves if we could, so as to spare them from it? The annoying thing about that, of course, is that then we would be in pain. Rats!

No, people - as in test subjects for a study to see how to alleviate headache pain in adults. In the Headache study mentioned above, 65 patients (aged 18-60) with chronic headaches were treated.1 In order to qualify for this parallel, randomized, double-blind study, each patient had to have had at least 15 days of headache each month for a period of at least 6 months; amazingly, 49 of them (75%) had had headaches every day of the month. The time since the onset of their chronic headache suffering ranged from 1 to 22 years, with a mean of 9.4 years. (Just thinking about all that is enough to give one a headache!)

During the 8-week treatment period, administration of 5-HTP (100 mg three times a day) reduced the number of days with headache by 37.5% from the baseline value established during a 2-week "washout period" at the outset of the trial. The placebo effect in the control group was strong, however, resulting in a 29.2% reduction in the number of days with headache, and the difference between the two groups was not statistically significant. (Judgments of this kind are mathematically objective, based on standard methods of data analysis that take all relevant factors into account.)

5-HTP GIVES RELIEF - IN A SURPRISING WAYDuring the 2-week period following the treatment, however, there was a statistically significant response - a carryover effect - in the 5-HTP group: the number of days with headache was reduced by 55.1% from the baseline value, versus only 27.2% in the control group.

In other words, the value for the 5-HTP group was considerably better during the follow-up period (the value for the control group was essentially unchanged). This makes it sound as though 5-HTP becomes more effective when you stop using it! That may be true, but only for awhile - the effect would surely not last very long. It's conceivable that alternating on/off periods of taking 5-HTP would actually work better than taking it continuously. More research is needed to answer this intriguing question.

In addition, when the patients rated their headache pain using a subjective 6-point scale (0 = very worst pain, 5 = no pain), the pain index reported by the control group during the 8-week treatment period was 2.65, whereas that reported by the 5-HTP group was significantly better: 3.11. During the 2-week follow-up period, the pain index remained virtually the same in the control group (2.64) but improved significantly in the 5-HTP group (3.41).

What Are Neurotransmitters?

Neurotransmitters are molecular messengers that allow adjacent neurons (nerve cells) to communicate with each another so as to propagate neural impulses, which are tiny electric currents. The molecules are produced at the end of one neuron, released into the synapse (the tiny space between two adjacent neurons), and detected by receptor sites at the end of the next neuron. This "completes the circuit" and allows the impulse to continue along the neural network. The receptor sites are molecular complexes that are highly specific for a given neurotransmitter, such as serotonin - they will respond only to those particular molecules or, in some cases, to molecules that are very similar in structure.

5-HTP USERS NEEDED FEWER ANALGESICSYet another important aspect of the study revealed that the patients in the 5-HTP group needed less pain relief than did those in the control group. For example, patients in the 5-HTP group consumed an average of only 3.0 analgesic tablets during the 8-week treatment period, while those in the control group averaged 11.9 tablets. (The analgesics were prescription drugs made available to them by the researchers, with the request that they avoid using them as much as possible.) During the 2-week follow-up period, when the number of days with headache was lower in the 5-HTP group (but not in the control group) than it was during the 8-week treatment period, the same trend was observed: the 5-HTP group consumed an average of 2.0 analgesic tablets, compared to 5.5 in the control group.

Vascular versus Nonvascular Headaches

There are many different types of headaches, but in general they fall into two distinct classes: vascular (referring to blood vessels) and nonvascular. The archetypal vascular headache is the migraine. A prevalent theory (which is now in some doubt) has been that the pain of migraine arises from an initial severe constriction of arteries to the brain, followed by a rebound dilation that activates nearby pain receptors. The cause is unknown, and the mechanism is far more complex than this description implies, but it is believed that the initial arterial contractions may be triggered by low serotonin levels.

Whatever the correct explanation for migraine may be, there is little doubt that serotonin is involved. That is why migraine is called a serotonin- deficiency syndrome, and it is why many of the treatments for migraine focus on restoring proper serotonin levels.

Nonvascular headaches, or tension headaches, are believed to be caused by tightening of the muscles in the scalp, face, neck, or shoulders, usually as a result of stress. This may trigger pain through a pinching effect on nerves and their blood supplies. Pain from nonvascular headaches is usually steady and may range in severity from a dull ache to excruciating pain. The pain typically has a single focal point, such as the forehead or base of the skull, and progressively spreads to engulf the entire head in a viselike grip.

Although 5-HTP has long been recommended for use in treating migraine headaches, there is a growing body of evidence that suggests it may benefit individuals who suffer from tension headaches as well. And because tension headaches represent about 90% of all headaches, additional research is being performed on this topic in an effort to alleviate the pain that this large segment of the population endures.

5-HTP: A NATURAL APPROACH TO CONQUER HEADACHESTaken together, the results described above suggest that 5-HTP may be moderately effective in limiting the pain of chronic tension-type headaches. In addition, 5-HTP lacks the side effect of sedation that is common with many widely used tricyclic antidepressants. Another feature that makes 5-HTP attractive for headache relief is that there is no change in weight or blood pressure associated with its use, which is not true of many other commercially available treatments.

5-HTP is a naturally occurring compound that is most commonly obtained from Griffonia simplicifolia (a relative of carob), a plant native to Africa. Smaller amounts of the compound are also found in less exotic plants, such as tomatoes, plums, walnuts, and eggplant.5

5-HTP is attractive for headache relief because there is no change in weight or blood pressure associated with its use.

So start boosting your serotonin levels. It may give you just the edge you need to overcome the stresses and rigors of daily life.